Healthcare Provider Details

I. General information

NPI: 1922265743
Provider Name (Legal Business Name): JOE X ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36TH MEDICAL GROUP UNIT 14010 BLDG. 26012
APO AP
96543-4003
US

IV. Provider business mailing address

777 SONGTAN BLVD,
APO AP
96266
US

V. Phone/Fax

Practice location:
  • Phone: 315-366-3882
  • Fax:
Mailing address:
  • Phone: 315-784-2002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01068899A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: